Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Cerebral Oxygen Metabolism in Adults with Sickle Cell Disease

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Harvard

VáclavŮ, L, Petr, J, Petersen, ET, Mutsaerts, HJ, Majoie, CB, Wood, JC, VanBavel, E, Nederveen, AJ & Biemond, BJ 2020, 'Cerebral Oxygen Metabolism in Adults with Sickle Cell Disease', American Journal of Hematology, bind 95, nr. 4, s. 401-412. https://doi.org/10.1002/ajh.25727

APA

VáclavŮ, L., Petr, J., Petersen, E. T., Mutsaerts, H. J., Majoie, C. B., Wood, J. C., VanBavel, E., Nederveen, A. J., & Biemond, B. J. (2020). Cerebral Oxygen Metabolism in Adults with Sickle Cell Disease. American Journal of Hematology, 95(4), 401-412. https://doi.org/10.1002/ajh.25727

CBE

VáclavŮ L, Petr J, Petersen ET, Mutsaerts HJ, Majoie CB, Wood JC, VanBavel E, Nederveen AJ, Biemond BJ. 2020. Cerebral Oxygen Metabolism in Adults with Sickle Cell Disease. American Journal of Hematology. 95(4):401-412. https://doi.org/10.1002/ajh.25727

MLA

Vancouver

Author

VáclavŮ, Lena ; Petr, Jan ; Petersen, Esben Thade ; Mutsaerts, Henri Jmm ; Majoie, Charles Bl ; Wood, John C ; VanBavel, Ed ; Nederveen, Aart J ; Biemond, Bart J. / Cerebral Oxygen Metabolism in Adults with Sickle Cell Disease. I: American Journal of Hematology. 2020 ; Bind 95, Nr. 4. s. 401-412.

Bibtex

@article{d9db45dbc4db4982bde66d3f95eb36ff,
title = "Cerebral Oxygen Metabolism in Adults with Sickle Cell Disease",
abstract = "In sickle cell disease (SCD), oxygen delivery is impaired due to anemia, especially during times of increased metabolic demand, and cerebral blood flow (CBF) must increase to meet changing physiologic needs. But hyperemia limits cerebrovascular reserve (CVR) and ischemic risk prevails despite elevated CBF. The cerebral metabolic rate of oxygen (CMRO 2) directly reflects oxygen supply and consumption and may therefore be more insightful than flow-based CVR measures for ischemic risk in SCD. We hypothesized that adults with SCD have impaired CMRO 2 at rest and that a vasodilatory challenge with acetazolamide would improve CMRO 2. CMRO 2 was calculated from CBF and oxygen extraction fraction (OEF), measured with arterial spin labeling and T 2-prepared tissue relaxation with inversion recovery (T 2-TRIR) MRI. We studied 36 adults with SCD without a clinical history of overt stroke, and nine healthy controls. As expected, CBF was higher in patients with SCD versus controls (mean ± SD: 74 ± 16 versus 46 ± 5 mL/100 g/min, P <.001), resulting in similar oxygen delivery (SCD: 377 ± 67 versus controls: 368 ± 42 μmol O 2/100g/min, P =.69). OEF was lower in patients versus controls (27 ± 4 versus 35 ± 4%, P <.001), resulting in lower CMRO 2 in patients versus controls (102 ± 24 versus 127 ± 20 μmol O 2/100g/min, P =.002). After acetazolamide, CMRO 2 declined further in patients (P <.01) and did not decline significantly in controls (P =.78), indicating that forcing higher CBF worsened oxygen utilization in SCD patients. This lower CMRO 2 could reflect variation between healthy and unhealthy vascular beds in terms of dilatory capacity and resistance whereby dysfunctional vessels become more oxygen-deprived, hence increasing the risk of localized ischemia. ",
author = "Lena V{\'a}clavŮ and Jan Petr and Petersen, {Esben Thade} and Mutsaerts, {Henri Jmm} and Majoie, {Charles Bl} and Wood, {John C} and Ed VanBavel and Nederveen, {Aart J} and Biemond, {Bart J}",
note = "{\textcopyright} 2020 The Authors. American Journal of Hematology published by Wiley Periodicals, Inc.",
year = "2020",
month = apr,
doi = "10.1002/ajh.25727",
language = "English",
volume = "95",
pages = "401--412",
journal = "American Journal of Hematology",
issn = "0361-8609",
publisher = "John/Wiley & Sons, Inc. John/Wiley & Sons Ltd",
number = "4",

}

RIS

TY - JOUR

T1 - Cerebral Oxygen Metabolism in Adults with Sickle Cell Disease

AU - VáclavŮ, Lena

AU - Petr, Jan

AU - Petersen, Esben Thade

AU - Mutsaerts, Henri Jmm

AU - Majoie, Charles Bl

AU - Wood, John C

AU - VanBavel, Ed

AU - Nederveen, Aart J

AU - Biemond, Bart J

N1 - © 2020 The Authors. American Journal of Hematology published by Wiley Periodicals, Inc.

PY - 2020/4

Y1 - 2020/4

N2 - In sickle cell disease (SCD), oxygen delivery is impaired due to anemia, especially during times of increased metabolic demand, and cerebral blood flow (CBF) must increase to meet changing physiologic needs. But hyperemia limits cerebrovascular reserve (CVR) and ischemic risk prevails despite elevated CBF. The cerebral metabolic rate of oxygen (CMRO 2) directly reflects oxygen supply and consumption and may therefore be more insightful than flow-based CVR measures for ischemic risk in SCD. We hypothesized that adults with SCD have impaired CMRO 2 at rest and that a vasodilatory challenge with acetazolamide would improve CMRO 2. CMRO 2 was calculated from CBF and oxygen extraction fraction (OEF), measured with arterial spin labeling and T 2-prepared tissue relaxation with inversion recovery (T 2-TRIR) MRI. We studied 36 adults with SCD without a clinical history of overt stroke, and nine healthy controls. As expected, CBF was higher in patients with SCD versus controls (mean ± SD: 74 ± 16 versus 46 ± 5 mL/100 g/min, P <.001), resulting in similar oxygen delivery (SCD: 377 ± 67 versus controls: 368 ± 42 μmol O 2/100g/min, P =.69). OEF was lower in patients versus controls (27 ± 4 versus 35 ± 4%, P <.001), resulting in lower CMRO 2 in patients versus controls (102 ± 24 versus 127 ± 20 μmol O 2/100g/min, P =.002). After acetazolamide, CMRO 2 declined further in patients (P <.01) and did not decline significantly in controls (P =.78), indicating that forcing higher CBF worsened oxygen utilization in SCD patients. This lower CMRO 2 could reflect variation between healthy and unhealthy vascular beds in terms of dilatory capacity and resistance whereby dysfunctional vessels become more oxygen-deprived, hence increasing the risk of localized ischemia.

AB - In sickle cell disease (SCD), oxygen delivery is impaired due to anemia, especially during times of increased metabolic demand, and cerebral blood flow (CBF) must increase to meet changing physiologic needs. But hyperemia limits cerebrovascular reserve (CVR) and ischemic risk prevails despite elevated CBF. The cerebral metabolic rate of oxygen (CMRO 2) directly reflects oxygen supply and consumption and may therefore be more insightful than flow-based CVR measures for ischemic risk in SCD. We hypothesized that adults with SCD have impaired CMRO 2 at rest and that a vasodilatory challenge with acetazolamide would improve CMRO 2. CMRO 2 was calculated from CBF and oxygen extraction fraction (OEF), measured with arterial spin labeling and T 2-prepared tissue relaxation with inversion recovery (T 2-TRIR) MRI. We studied 36 adults with SCD without a clinical history of overt stroke, and nine healthy controls. As expected, CBF was higher in patients with SCD versus controls (mean ± SD: 74 ± 16 versus 46 ± 5 mL/100 g/min, P <.001), resulting in similar oxygen delivery (SCD: 377 ± 67 versus controls: 368 ± 42 μmol O 2/100g/min, P =.69). OEF was lower in patients versus controls (27 ± 4 versus 35 ± 4%, P <.001), resulting in lower CMRO 2 in patients versus controls (102 ± 24 versus 127 ± 20 μmol O 2/100g/min, P =.002). After acetazolamide, CMRO 2 declined further in patients (P <.01) and did not decline significantly in controls (P =.78), indicating that forcing higher CBF worsened oxygen utilization in SCD patients. This lower CMRO 2 could reflect variation between healthy and unhealthy vascular beds in terms of dilatory capacity and resistance whereby dysfunctional vessels become more oxygen-deprived, hence increasing the risk of localized ischemia.

UR - http://www.scopus.com/inward/record.url?scp=85078656014&partnerID=8YFLogxK

U2 - 10.1002/ajh.25727

DO - 10.1002/ajh.25727

M3 - Journal article

C2 - 31919876

VL - 95

SP - 401

EP - 412

JO - American Journal of Hematology

JF - American Journal of Hematology

SN - 0361-8609

IS - 4

ER -

ID: 59013068